Transfer Medicine

Published: 15/08/2019

Transfer Medicine

The learning outcomes and competencies listed are those necessary for the first 24 months of anaesthetic training. It is strongly recommended that CT 1/2 trainees complete this unit of training before undertaking intra-hospital transfer with distant supervision. Many of the competencies may be attained whilst gaining training and experience in intensive care.

Learning outcomes:

Correctly assesses the clinical status of patients and decides whether they are in a suitably stable condition to allow intra-hospital transfer [only]
Gains understanding of the associated risks and ensures they can put all possible measures in place to minimise these risks

Core clinical learning outcome:

Safely manages the intra-hospital transfer of the critically ill but stable adult patient for the purposes of investigations or further treatment [breathing spontaneously or with artificial ventilation] with distant supervision

NB: All competencies annotated with the letter ‘E’ can be examined in any of the components of the Primary examination identified in the FRCA examination blueprint on page B-99 or in the Final examination identified in the Final FRCA blueprint on page C72 of Annex C.

Knowledge

Competence	Description	Assessment Methods	GMP
TF_BK_01	Explains the importance of ensuring the patient’s clinical condition is optimised and stable prior to transfer	A,C,E	1,2
TF_BK_02	Explains the risks/benefits of intra-hospital transfer	A,C,E	1,2
TF_BK_03	Recalls/describes the minimal monitoring requirements for transfer	A,C,E	1,2,3
TF_BK_04	Lists the equipment [and back up equipment] that is required for intra-hospital transfer	A,C,E	1,2
TF_BK_05	Outlines the physical hazards associated with intra-hospital transfer	A,C,E	1,2
TF_BK_06	Explains the problems caused by complications arising during transfer and the measures necessary to minimise and pre-empt difficulties	A,C,E	1
TF_BK_07	Outlines the basic principles of how the ventilators used for transfer function	A,C,E	1
TF_BK_08	Indicates the lines of responsibility that should be followed during transfer	A,C,E	1,2,3
TF_BK_09	Outlines the consent requirements and the need to brief patients in transfer situations	A,C,E	1,2,3,4
TF_BK_10	Outline the issues surrounding the carrying/recording of controlled drugs during transfer	A,C,E	1,2,3
TF_BK_11	Describes the importance of keeping records during transfer	A,C,E	1
TF_BK_12	Outlines the problem of infection and contamination risks when moving an infected patient	A,C,E	1,2
TF_BK_13	Explains how to assess and manage an uncooperative and aggressive patient during transfer	A,C,E	1,2,3,4
TF_BK_14	Understands hospital protocols governing transfer of patients between departments	A,C,E	1
TF_BK_15	Outlines the importance of maintaining communication, when appropriate with the patient and members of the transfer team.	A,C,E	1,2

Skills

Competence	Description	Assessment Methods	GMP
TF_BS_01	Demonstrates the necessary organisational and communication skills to plan, manage and lead the intra- hospital transfer of a stable patient	A,M	1,2,3,4
TF_BS_02	Demonstrates how to set up the ventilator and confirm correct functioning prior to commencing transfer	A,D	1,2
TF_BS_03	Demonstrates safety in securing the tracheal tube securely prior to commencing the movement/transfer	A,D	1,2
TF_BS_04	Demonstrates the ability to calculate oxygen and power requirements for the journey	A,D	1,2
TF_BS_05	Demonstrates safety in securing patient, monitoring and therapeutics before transfer	A,D	1,2,3,4
TF_BK_06	Demonstrates how to check the functioning of drug delivery systems	A,D	2,3
TF_BS_07	Demonstrates appropriate choices of sedation, muscle relaxation and analgesia to maintain the patient’s clinical status during transfer	A,C,D,M	1,2
TF_BS_08	Demonstrates the ability to maintain monitoring of vital signs throughout transfer	A,D	1,2
TF_BS_09	Demonstrates the ability to maintain clinical case recording during transfer	C,M	1